Stent having at least one connecting member configured to controllably sever in vivo

ABSTRACT

A stent may include a connector having a first portion, a second portion, and a third portion positioned between the first and second portions. The connector may be configured to interconnect axially adjacent stent segments. The connector may be further configured such that the third portion severs in response to a threshold amount of axial force, axial foreshortening, and/or cyclic loading or fatigue, in order to predispose the severance of one or more pre-configured connectors in a controlled manner to minimize any potential harm to the surrounding vasculature of a patient.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a divisional of U.S. application Ser. No.13/403,793, filed on Feb. 23, 2012, now allowed, which claims priorityto U.S. Provisional Patent Application No. 61/446,031, filed Feb. 23,2011, both of which are hereby incorporated by reference in theirentirety.

INCORPORATION BY REFERENCE

U.S. Pat. No. 6,488,702, filed on Jan. 23, 1998, entitled BISTABLESPRING CONSTRUCTION FOR A STENT AND OTHER MEDICAL APPARATUS, U.S. patentapplication Ser. No. 11/875,718, filed on Sep. 19, 2007, entitledDEFORMABLE LUMEN SUPPORT DEVICES AND METHODS OF USE, and U.S. patentapplication Ser. No. 11/391,940, filed on Mar. 29, 2006, entitled“FRACTURE-RESISTANT HELICAL STENT INCORPORATING BISTABLE CELLS ANDMETHODS OF USE,” which are attached hereto as Exhibit A, are herebyincorporated by reference in their entireties as if fully set forthherein.

BACKGROUND OF THE DISCLOSURE Technical Field

The present disclosure relates to stents, more particularly, tointerconnections, connectors, and interconnects between adjacent, e.g.axially adjacent, stent segments.

It is known by persons skilled in the art that a stent positioned inblood vessels adjacent joints or bending planes of the body, such as asuperficial femoral artery (SFA), can experience repeated and extremeaxial loads or displacements in use. For this reason, some embodimentsof the stents positioned within the SFA or other such locationspreferably are axially resilient or springy, as opposed to being axiallyrigid. In some cases, coiled stents have been used in these locations,but such stents often do not deploy well or cover the vessel or passagewall well. It may be desirable to provide stents having improvedperformance in this environment.

SUMMARY OF SOME EXEMPLIFYING EMBODIMENTS

In one embodiment, a stent is provided that comprises a connector. Theconnector includes a first portion, a second portion, and a thirdportion positioned between the first and second portions. The connectoris configured to interconnect axially or longitudinally adjacent stentsegments. The connector is configured such that the third portionthereof severs in a controlled manner during or after deployment.

For example, the stent can be configured to induce sufficient stress inthe third portion under the forces that arise within a vessel that iscompressed due to bending of the human anatomy, e.g., at a bendingplane. As such, the third portion can be configured to sever at apredetermined axial force, which may be applied by the vasculature alongthe length of the stent.

In some embodiments, the third portion is configured to sever when undera predetermined percent of axial foreshortening, such as once the stenthas been shortened by approximately 3% percent or more due to an appliedload.

In some embodiments, the third portion can be configured to sever uponexceeding a predetermined number of cycles of loading such that thestent comprises a unitary body from proximal to distal end for at leastan initial period after deployment and thereafter separates into aplurality of adjacent scaffolding segments after the initial period.

In another embodiment, an expandable device is provided that includes atleast first and second cells that are connected by a load absorbingmember. The load absorbing member can be configured to accommodate foran axial load placed on the expandable device such that the expandablemember can scaffold, e.g., hold open, a passage or lumen, and can at thesame time accommodate axial contraction of the passage or lumen.

The load absorbing member can be configured as a breakable member thatenables the expandable member to be delivered in a unitary state andthereafter separate into at least two separate structures during orafter deployment. In some embodiments, one or more connecting members ofan expandable device break and one or more connecting members of theexpandable device remain intact. For example, where bending is primarymode of deformation of the expandable device, not all membersnecessarily break. In some embodiments, breakable members that aresubject to largest strains in bending break to create higher flexibilityfor bending while other members can remain intact. As a result theflexibility of the stent can be enhanced during or after delivery whilethe stent does not separate into two or more separate structures.

In one arrangement, a breakable member can comprise a first portioncoupled with the first cell and a second portion coupled with the secondcell. The breakable member can be configured to fracture between thefirst and second cells in a controlled manner. For example, thebreakable member can be configured to fracture under a pre-determinedaxial load. The breakable member can be configured to fracture under anumber of axial compression cycles. The breakable member can beconfigured to fracture upon expansion.

In some applications, further advantage is provided by shieldingsurfaces that are exposed due to fracture of a breakable member.Shielding surfaces exposed due to fracture can be accomplished byproviding atraumatic structures on at least two sides of thefracture-exposed surface. For example, the connector can comprise firstand second portions that extend between the breakable member and cellsof the expandable member, where the first and second portions areconfigured to shield the fracture-exposed surfaces.

In some techniques, fracture-exposed surfaces can be oriented or can beconfigured to face in a direction expected to have the least movement orcontraction during cycles. For example, in the superficial femoralartery, greater foreshortening is expected along the length of thevessel than about the circumference. Thus, there may be advantage inorienting the fracture-exposed surface generally circumferentially insuch applications.

In some embodiments, the breakable portion extends directly betweencells of the expandable device and the cells are constructed to shieldfracture-exposed surfaces.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing summary, as well as the following detailed description ofthe preferred embodiments of the present invention, will be betterunderstood when read in conjunction with the appended drawings, inwhich:

FIG. 1 is a plan view of a pattern of an embodiment of a stent.

FIG. 2A is an enlarged view of a portion of the stent pattern shown inFIG. 1, defined by curve 2-2 of FIG. 1, showing the connector before aportion thereof has been severed.

FIG. 2B is an enlarged view of a portion of the stent pattern shown inFIG. 1, defined by curve 2-2 of FIG. 1, showing the connector after aportion thereof has been severed.

FIG. 3 is photograph of a connector, such as the connector defined bycurve 3-3 of FIG. 1.

FIG. 4A is a perspective view of a portion of another embodiment of aconnector and stent cell after a portion of the connector has beensevered.

FIG. 4B is another perspective view of the embodiment of the connectorand stent cell illustrated in FIG. 4A after a portion of the connectorhas been severed.

FIG. 4C is another perspective view of the embodiment of the connectorand stent cell illustrated in FIG. 4A after a portion of the connectorhas been severed.

FIG. 5A is a perspective view of a portion of an embodiment of abreakable connector after a portion of the connector has been severed.

FIG. 5B is another perspective view of the embodiment of the breakableconnector illustrated in FIG. 5A after a portion of the connector hasbeen severed.

FIG. 5C is another perspective view of the connector illustrated in FIG.5A after a portion of the connector has been severed.

FIG. 5D is a plan view of another embodiment of a connector after theconnector has been severed.

FIG. 5E is a plan view of another embodiment of a connector after theconnector has been severed.

FIG. 5F is a plan view of another embodiment of a connector after theconnector has been severed.

FIG. 6 is an enlarged plan view of another embodiment of a connector.

FIG. 7 is an enlarged plan view of another embodiment of a connector.

FIG. 8 is a schematic illustration of the zone or pocket of protectionprovided to the severed portion of the connector by each of the firstand second portions of the connector illustrated in FIG. 7.

FIG. 9 is an enlarged plan view of another embodiment of a connector.

FIG. 10 is an enlarged plan view of another embodiment of a connector.

FIG. 11 is an enlarged plan view of another embodiment of a connector.

FIG. 12 is an enlarged plan view of another embodiment of a connector.

FIG. 13 is an enlarged plan view of another embodiment of a connector.

FIG. 14 is an enlarged plan view of another embodiment of a connector.

FIG. 15 is an enlarged plan view of another embodiment of a connector.

FIG. 16 is an enlarged plan view of another embodiment of a connector.

FIG. 17 is an enlarged plan view of another embodiment of a connector.

FIG. 18 is an enlarged plan view of another embodiment of a stent havinga connector between two portions of a stent cell or segment.

FIG. 19A is an enlarged view of another embodiment of a connector,showing the connector in a first or extended position.

FIG. 19B is an enlarged view of the embodiment of the connector shown inFIG. 13A, showing the connector in a second or contracted position.

FIG. 20A is an enlarged view of another embodiment of a connector,showing the connector in a first or extended position.

FIG. 20B is an enlarged view of the embodiment of the connector shown inFIG. 5A, showing the connector in a second or contracted position.

FIG. 21 is a perspective view of an embodiment of a helically arrangedstent having one or more severable connectors, showing the stent in acompressed state.

FIG. 22 is a perspective view of an embodiment of a helically arrangedstent having one or more severable connectors, showing the stent in anexpanded state.

FIG. 23 is a plan view of a portion of a pattern of another embodimentof a stent.

FIG. 23A is a schematic representation of a portion of the pattern ofthe embodiment of a stent illustrated in FIG. 23, showing theinterdigitated stent cells in a relaxed and contracted state.

FIG. 24A is a plan view of a portion of another embodiment of a stenthaving a connector between at least two portions of a stent cell orsegment.

FIG. 24B is a plan view of a portion of another embodiment of aconnector configured to provide a connection between at least twoportions of a stent cell or segment.

FIG. 25 is a plan view of a portion of another embodiment of a stenthaving a connector between at least two stent segment portions.

FIG. 26 is a plan view of a portion of another embodiment of a stenthaving a connector between at least two portions of a stent cell orsegment.

FIGS. 27-37 set forth additional details regarding some embodiments ofthe stents and connectors disclosed herein.

DETAILED DESCRIPTION OF SOME EXEMPLIFYING EMBODIMENTS

The following detailed description is now directed to certain specificembodiments of the disclosure. In this description, reference is made tothe drawings wherein like parts are designated with like numeralsthroughout the description and the drawings.

Certain embodiments described herein are directed to systems, methods,and apparatuses to treat stenosis, lesions, or other defects in tubularstructures like blood vessels, including, but not limited to, the aorta,iliac arteries or veins, coronary arteries, femoral arteries, thoracicarteries, and/or the superficial femoral artery, to name a few. However,the systems, methods, and apparatuses may have application to othervessels or areas of the body such as biliary vessels or ducts, or toother fields, and such additional applications are intended to form apart of this disclosure. And, while specific embodiments may bedescribed herein with regard to particular portions of a person'svasculature, it is to be understood that the embodiments described canbe adapted for use in other portions of a person's or animal'svasculature or other portions of the body and are not limited to thespecific blood vessels specified herein.

A stent positioned in blood vessels adjacent joints or bending planes ofthe body, such as a superficial femoral artery, can experience repeatedand extreme axial loads or displacements in use. For this reason, someembodiments of the stents positioned within the SFA or other suchlocations preferably are axially resilient or springy, as opposed tobeing axially rigid. In some cases, coiled stents have been used inthese locations, but such stents often do not deploy well or cover thevessel or passage wall well. Generally, without limitation, some stentembodiments disclosed herein provide improved performance in thisenvironment, for example providing a controlled deployment thereof. Insome embodiments, stents are provided with severable or breakableconnectors (also referred to herein as interconnectors) that aredesigned to sever or break when the stent experiences a threshold orpredetermined displacement, a threshold force, or when the stentexperiences a threshold or predetermined level of cyclic loading orfatigue. The calculated metal fatigue yield threshold will depend inpart on the target vessel domain or clinical indication. For example,Dr. Smouse et. al (Endovascular Today (1) June 2005) showed in a humancadaver study that the bare SFA shortens between 5 and 23% and a stentimplanted in the SFA shortens on average between 4 and 14% with kneeflexion. Thus for the SFA it may be best to have a device yield at adegree of foreshortening at or below these percentages, for example someembodiments have connectors that break at or less than 3%foreshortening. The levels of foreshortening at which the connectorsbreak may be much lower in venous and coronary vessels and much higherin hemodialysis outflow stenosis as examples. The target foreshorteningrange after severing inter-connects will be between 2% and 25% for mostapplications.

In some cases, it is desirable to configure the interconnect to break orsever at or above a level of force. For example, in some applications0.8 pounds or less force can result in breaking of an interconnect in anSFA application.

For example, without limitation, some embodiments of the stentsdisclosed herein can be configured such that one or more axialconnectors sever or separate when the stent experiences an axialforeshortening of approximately 2% or more. In some cases, a higherthreshold of foreshortening may be appropriate. For example,interconnects can be configured to disengage after a number of cycles ofshortening that exceed 3%. In some applications, interconnects can bearranged that disengage after a number of cycles of more than about 5%foreshortening occur. Some interconnect can be arranged to not disengageuntil a number of cycles of shortening greater than 10% occur and insome cases as much as 20%. The threshold for stent foreshortening tocause fracture will be much less than the expected need for overallstent foreshortening in most embodiments. The distance between thecircumferential structures or rings after release or disengagement ofinterconnects can be designed based on the intended anatomy. The overallstent axial compressibility for the SFA applications as an example wouldbe between 5 and 25%.

After one or more connectors have become severed or portions of adjacentstent segments have become disengaged, the stent can be more flexible inat least the axial direction to better accommodate the foreshortening orstretching of the vessel or passageway that the stent is positionedwithin. Additionally, in some embodiments, delivery and deployment of astent with unsevered connectors may be easier and safer for the patient.In some cases, segments along the length of the stent can be completelyseparated from each other due to severing of one or more connectors.

Accordingly, some embodiments of the stents disclosed herein can beconfigured to compress or foreshorten by approximately 25%, or betweenapproximately 10% and approximately 40%. Some embodiments of the stentsdisclosed herein can be configured to compress or foreshorten betweenapproximately 10% and approximately 20%, or between approximately 20%and approximately 30%, or between approximately 30% and approximately40% of its axially uncompressed length, or to or from any values withinthese ranges.

In some embodiments, the connectors between axial segments can beconfigured so as to sever or separate at a threshold force at apredetermined location of the connector. For example, withoutlimitation, a portion of a connector can have a reduced cross-sectionalarea or thickness and can be otherwise configured so as to sever orseparate when the stent experiences a predetermined axial force orforeshortening.

Additionally, in some embodiments, the connectors between axial segmentscan be configured so as to sever or separate at a predetermined locationof the connector when a threshold force is imparted on the stent orconnector. For example, without limitation, a portion of a connector canhave a reduced cross-sectional area and can be otherwise configured soas to sever or separate when the stent experiences a predetermined axialforce or foreshortening, or after the stent or connector has undergone apredetermined level of cyclic loading or fatigue.

Additionally, in some embodiments, the connectors can be formed of thesame material as the cells of the stent, or can be partially orsubstantially completely formed from a bioabsorbable or biodegradablematerial that is configured to degrade or be bioabsorbed by the bodyafter a predetermined period of time. In this configuration, theconnector can be weakened so as to be more easily severable after apredetermined period of time, or can be completely bioabsorbed so as toremove the connection between adjacent stent segments after apredetermined period of time.

FIG. 1 shows a plan view of a pattern of an embodiment of a stent 10having a plurality of stent segments 12 comprising a plurality of stentcells 14. In some embodiments, the stent cells 14 of each stent segment12 can be interconnected in a circumferential direction. In use, thestent 10 can define a generally straight or curved cylindrical ortubular shape. The stent cells 14 or any other cells disclosed hereincan be, but are not required to be, bistable cells, multistable cells,deformable unit cells, open cells, or other cells of the types disclosedin U.S. Pat. No. 6,488,702, filed on Jan. 23, 1998, entitled BISTABLESPRING CONSTRUCTION FOR A STENT AND OTHER MEDICAL APPARATUS, or U.S.patent application Ser. No. 11/875,718, filed on Sep. 19, 2007, entitledDEFORMABLE LUMEN SUPPORT DEVICES AND METHODS OF USE, both of which arehereby incorporated by reference as if fully set forth herein. In someembodiments, the stent cells 14 or any other cells disclosed orincorporated by reference herein can be similar to those of anyexpandable stents currently known or later developed, including withoutlimitation self-expandable cells, and balloon or other mechanicallyexpandable cells or any combination of any of the foregoing. Further, insome embodiments, the stent segments 12 can have an open stent pattern(serpentine or otherwise) comprising a series of concave and convexbends, or any other suitable structure.

In some embodiments, one or more adjacent stent segments 12 can beinterconnected by one or more, or by any combination of, curved orstraight connectors such as, without limitation, curved connector 16(which can be generally configured to withstand breakage during axialloading in normal operating conditions), while other adjacent stentsegments 12 can be interconnected by one or more severable connectors18. In some embodiments, all of the adjacent stent segments 12 can beinterconnected by one or more severable connectors 18.

FIG. 2A is an enlarged view of a portion of the stent pattern shown inFIG. 1, defined by curve 2-2 of FIG. 1. In particular, FIG. 2A is anenlarged view of the embodiment of the severable connector 18 shown inFIG. 1, the connector 18 being positioned between stent segment 12 a andstent segment 12 b. With reference to FIG. 2A, the severable connector18 can comprise a first portion 22, a second portion 24, and a severableor third portion 26. The third portion 26 can be configured to becomesevered when the stent 10 experiences a threshold axial force or axialforeshortening, as described above.

In some embodiments, the third portion 26 can have a reducedcross-sectional area as compared to the first and second portions 22, 24of the connector 18. In some embodiments, with reference to FIG. 2A, thethickness of the third portion 26 of the connector 18 can be reduced ineither or both of the x and y directions. In some embodiments, thethickness of the third portion 26 of the connector 18 can be reduced inany or all of the x, y, and z directions, wherein the x-direction isparallel with the longitudinal axis of the stent, the y-direction isperpendicular to the longitudinal axis of the stent, and the z-directionis in perpendicular to both the x and y-directions (e.g., the radialdirection relative to the stent).

In some embodiments, the cross-sectional area of the third portion 26 ofthe connector 18 can be approximately 50% less than a cross-sectionalarea of either or both of the first and second portions 22, 24 of theconnector 18. Some embodiments of the connector 18 can be configuredsuch that the third portion 26 of the connector 18 can have across-sectional area that is from approximately 20% to approximately 70%less than a cross-sectional area of either or both of the first andsecond portions 22, 24 of the connector 18, or from approximately 30% toapproximately 50% less than a cross-sectional area of either or both ofthe first and second portions 22, 24 of the connector 18, or to or fromany values within these ranges.

The connector 18 can be configured such that the third portion 26undergoes a shear failure when a predetermined axial force orforeshortening is reached. For example, without limitation, theconnector 18 can be configured such that the third portion 26 of theconnector 18 experiences a significantly greater magnitude of shearstrain than either of the first or second portions 22, 24 when the stentis axially foreshortened or compressed, or axially lengthened orstretched, or when torsional forces are imparted on the stent. Withreference to FIG. 2A, arrows A1 and A2 represent directional vectors ofa force that may be imparted on the connector 18 by stent segment 12 aand stent segment 12 b, respectively, when the stent 10 is compressed oraxially foreshortened. As illustrated, the third portion 26 can beconfigured such that the cross-sectional area of the third portion 26 ina direction parallel to the force vectors A1 and A2 is less than thecross-sectional area of either of the first or second portions 22, 24 ina direction parallel to the force vectors A1 and A2 such that the thirdportion 26 fails in shear before either of the first or second portions22, 24 fail. As such, the reduction of cross-section is one example ofwhere the connector 18 is specifically configured to shear or break at aparticular location. Other techniques can be used to configure aparticular portion of the connector 18 to break such that partial orcomplete separation of adjacent circumferential portions of the stent 10results. As a result the stent 10 is configured to provide adequatescaffolding and a sufficient prevention of prolapse of the vessel whileat the same time enhancing flexibility to accommodate the repeatedlengthening and shortening associated with an anatomical bending plane.

FIG. 2B is an enlarged view of a portion of the stent 10 pattern shownin FIG. 1, defined by curve 2-2 of FIG. 1, showing a schematicillustration of the connector 18′ after the third portion 26′ thereofhas been severed in response to an axial foreshortening of the stent 10,an axial force exerted on the stent 10, or a number of cycles ofcompression and tension applied thereto, and associated strain. Asillustrated in FIG. 2B, after all of the connectors 18′ interconnectingstent segments 12 a, 12 b have severed, the stent segments 12 a, 12 bcan then be free to axially translate in the axial directionsrepresented by arrows A3 and A4 relative to one another.

Further, with reference to FIGS. 1-2B, the first and second portions 22,24 of the connectors 18 can be configured to partially or fully surroundthe third portion 26 of the connector 18 such that, after becomingsevered, the potentially rough or jagged edges of the severed thirdportion 26′ are shielded from the anatomy or other portions of thestent. The third portion can be shielded by being partially or fullysurrounded in the x and y, or the axial, radial, and/or circumferentialdirections, thereby reducing the level of exposure of the severedconnector. This configuration can prevent or reduce direct contact fromthe severed third portion 26′ with other portions of the stent oradjacent body tissue. Additionally, as discussed above, the thickness ofthe third portion 26 can be reduced in a radial direction, for example,in the z-direction of the connector 18 shown in FIG. 2B, to furthershield a patient's vasculature or other tissue from the potentiallyrough or jagged edges of the severed third portion 26′.

In some embodiments, as in the embodiment illustrated in FIGS. 1-2B, thecells 14 can each comprise a thick strut 30 and a thin strut 32 incommunication with the thick strut 30. In this configuration, theconnector 18 can be supported by the thick strut 30 of each of theadjacent cells 14 of the adjacent stent segments 12 a, 12 b. However, inother embodiments, the connector 18 can be supported by the thin strut32 of either or both of the adjacent cells 14 of the adjacent stentsegments 12 a, 12 b. Further, the connector 38 can be used tointerconnect any desired portion of adjacent stent segments (having anopen or closed cell structure, open serpentine pattern, or otherwise)and are, thus, not limited to interconnecting bistable stent cells asillustrated in some of the figures.

FIG. 3 is photograph of an embodiment of a connector 38, such as theconnector 38 defined by curve 3-3 of FIG. 1. As shown in FIG. 3, theorientation of the connector 38 can be reversed as compared to theorientation of the connector 18. This can be due to the differingorientation of the cells 14 in the stent segment 14 c as compared to thecells 14 of the stent segment 14 a.

FIGS. 4A-4C are perspective views of a portion of another embodiment ofa connector 50 and stent cell 12 after a portion of the connector 50 hasbeen severed. The connector 50 can be used to interconnect any desiredportion of adjacent stent segments (having an open or closed cellstructure, open serpentine pattern, or otherwise) and are, thus, notlimited to interconnecting bistable stent cells as illustrated in someof the figures.

With reference to FIGS. 4A-4C, the first portion 52 and a second portion(not illustrated) of the connector 50 can be configured to fullysurround a severable or third portion 56 of the connector 50 such that,after becoming severed, the potentially rough or jagged edges of thesevered third portion 56 are shielded from the anatomy or adjacentportions of the stent (which can be a covered or uncovered stent). Thethird portion can be shielded by being partially or fully surrounded inthe axial, radial, and/or circumferential directions (similar toconnector 18 described above). This arrangement is one way to reduce thelevel of exposure of the severed connector 50, e.g., to reduce theinteraction between a vessel wall and the third portion 56. In someembodiments, it is sufficient that at least one of the first portion 52and a second portion (not shown in FIGS. 4A-4C) partially surround orshield the third portion 56. This configuration can prevent or reducedirect contact from the severed third portion 56 with other portions ofthe stent or adjacent body tissue. Additionally, the thickness of thethird portion 56 can be reduced in a radial direction to further shielda patient's vasculature or other tissue from the potentially rough orjagged edges of the severed third portion 56. In this context, the“radial direction” is the direction generally perpendicularly away froma central longitudinal axis of the passage defined through the stent.

FIGS. 5A-5C are perspective views of a portion of a generallyun-shielded severed connector 60, and FIGS. 5D-5F are plan view of otherconnectors after a portion of each connector has been severed. Incontrast with other embodiments shown herein, such as connector 50, theconnectors 60, 60′ shown in FIGS. 5A-5F are not configured to partiallyor fully surround the severed portion or end of the connectors after theconnectors have severed and are not atraumatic when artery undergoesbending or axial compression. As such, these connectors would be suitedfor vessels that do not experience bending or foreshortening or areotherwise unlikely to move relative to the severed ends. If such designswere deployed in the SFA or other vessel subject to bending, the endportion could cause damage to the vessel or irritation tending toproduce restenosis. Thus, the embodiments with pockets and those thatare shielded are more advantageous for the SFA and other similarvessels.

FIG. 5E illustrates one technique for controlling the separation of twolongitudinally offset segments of a stent. The connector 60′ can beformed with a portion that is configured to break in a controlledfashion. The connector 60′ can be configured to concentrate stress at apre-selected location so that a strain yield point can be reached atforces that are encountered in use. For example, the connector 60′ canbe configured to produce sufficient stress to be plastically deformedand in some cases rupture when subjected to forces generated in an SFAwhen the knee bends or has reached a predetermined number of straincycles. Other similar forces generated at bending planes of the bodycould be the basis for defining a configuration of the connector 60′. Inthe embodiment of FIG. 5E, the connector has a portion 61 that hasreduced cross-section compared to other portions of the connector 60′.

FIG. 6 is an enlarged plan view of another embodiment of a connector 70.The connector 70 can be used to interconnect any desired portion ofadjacent stent segments (having an open or closed cell structure, openserpentine pattern, or otherwise) and are, thus, not limited tointerconnecting bistable stent cells as illustrated in some of thefigures.

With reference to FIG. 6, the first and second portions 72, 74 of theconnector 70 can be configured to partially or fully surround aseverable or third portion 76 of the connector 70 such that, afterbecoming severed, the potentially rough or jagged edges of the severedthird portion 76 are shielded from the anatomy or adjacent portions ofthe stent. The third portion can be shielded by being partially or fullysurrounded in the axial, radial, and/or circumferential directions(similar to connector 18 described above), thereby reducing the level ofexposure of the severed connector 70. This configuration can prevent orreduce direct contact from the severed third portion 76 with otherportions of the stent or adjacent body tissue. Additionally, thethickness of the third portion 76 can be reduced in a radial direction,as defined above, to further shield a patient's vasculature or othertissue from the potentially rough or jagged edges of the severed thirdportion 76.

As illustrated, the first and second portions 72, 74 can haveatraumatic, curved end portions 72 b, 74 b to protect a patient'svasculature or other tissue and to substantially surround the thirdportion 76. Further, the edges of the first and second portions 72, 74can be smooth or rounded to further protect a patient's vasculature orother tissue. Further, as illustrated, depressions or recesses 78 can beformed in the second end portions 72 b, 74 b surrounding the thirdportion 76. In some embodiments, the depressions 78 can effectivelyincrease the length of the third portion 76 to increase the flexibilityof the third portion 76, while also limiting the exposed length of thethird portion 76 after the third portion 76 has been severed. In somecases, the third portion 76 can be configured to rupture at a locationat or within the depression 78 to provide further shielding of a rupturezone of the connector 70.

FIG. 7 is an enlarged plan view of another embodiment of a connector 90.The connector 90 can be used to interconnect any desired portion ofadjacent stent segments (having an open or closed cell structure, openserpentine pattern, or otherwise) and are, thus, not limited tointerconnecting bistable stent cells as illustrated in some of thefigures. In some embodiments, the embodiment of the connector 90illustrated in FIG. 7 can be configured to sever or break when apredetermined load, level of fatigue, or displacement is experienced bythe connector 90, while also being configured to shield adjacent bodytissue, stent material, graft material (if the stent is a coveredstent), or other adjacent objects from contact with the severed portionof the connector 90 after the connector 90 has severed.

With reference to FIG. 7, the first and second portions 92, 94 of theconnector 90 can be configured to partially or fully surround aseverable or third portion 96 of the connector 90. In thisconfiguration, after becoming severed, the edges of the severed thirdportion 96 can be partially or fully surrounded by the first and/orsecond portions 92, 94, thereby reducing the level of exposure of thesevered third portion 96. For example, in some variations, the thirdportion 96 can be shielded in the axial directions by the first andsecond portions 92, 94 of the connector 90. In other embodiments, thethird portion 96 can be shielded in the radial direction. In otherembodiments, the third portion can be shielded in the circumferentialdirection. In some variations, the third portion 96 can be shielded inthe axial, radial, and circumferential directions. This configurationcan prevent or reduce direct contact from the severed third portion 96with other portions of the stent or adjacent body tissue. Additionally,the thickness of the third portion 96 can be reduced in a radialdirection to further shield a patient's vasculature or other tissue fromthe potentially rough or jagged edges of the severed third portion 96.

As illustrated, the first and second portions 92, 94 can haveatraumatic, angled end portions 92 b, 94 b to substantially surround thethird portion 96. The angled end portions 92 b, 94 b advantageously canbe oriented such that they are disposed between the ruptured ends of theconnector 90 and other portions of the stent or adjacent body tissue toprevent or reduce direct contact from the ruptured ends with otherportions of the stent or adjacent body tissue. This arrangement canlimit interactions between a severed portion of the connector 90 andstent cells or other structures providing scaffolding of the vessel.Further, the edges of the first and second portions 92, 94 can be smoothor rounded to provide greater protection to a patient's vasculature orother tissue.

FIG. 8 is a schematic illustration of the zone or pocket of protectionprovided to the severed third portion 96 of the connector 90 by thefirst portion 92 of the connector 90 illustrated in FIG. 6. The zone orpocket of protection is schematically illustrated as the cross-hatchedarea surrounding the third portion 96 of the connector 90. In someembodiments, the zone of protection projects from the distal end of thesecond portion 92 b toward the stent cell 14 and represents the area orzone of protection surrounding the severed third portion 96 provided bythe angled end portion 92 b of the first portion 92 of the connector 90.In other words, the angled end portion 92 b of the first portion 92partially surrounds the severed third portion 96 to inhibit or preventadjacent stent portions or other objects from projecting into the zoneof protection. The embodiment of the second portion 94 illustrated inFIG. 6 is similarly configured.

FIG. 9 is an enlarged plan view of another embodiment of a connector110. The connector 110 can be used to interconnect any desired portionof adjacent stent segments (having an open or closed cell structure,open serpentine pattern, or otherwise) and are, thus, not limited tointerconnecting bistable stent cells as illustrated in some of thefigures.

With reference to FIG. 9, the first and second portions 112, 114 of theconnector 110 can be configured to partially or fully surround aseverable or third portion 116 of the connector 110 such that, afterbecoming severed, the potentially rough or jagged edges of the severedthird portion 116 are shielded from the anatomy or adjacent portions ofthe stent. The third portion can be shielded by being partially or fullysurrounded in the axial, radial, and/or circumferential directions(similar to connector 18 described above), thereby reducing the level ofexposure of the severed connector 110 with adjacent tissue or stentportions. Additionally, the thickness of the third portion 116 can bereduced in a radial direction to prevent or reduce direct contact fromthe severed third portion 116 with other portions of the stent oradjacent body tissue.

As illustrated, the first and second portions 112, 114 can haveatraumatic, round end portions 112 b, 114 b, similar to the geometry ofa stent with radiopaque markers, to further protect a patient'svasculature or other tissue and to substantially surround the thirdportion 116. In one embodiment, at least one of the end portions 112 b,114 b comprises a radiopaque marker and the third portion 116 isdisposed between the portions 112 b, 114 b. For example, the thirdportion 116 can comprise a structure is located on a distal facing edgeof a proximal portion of the end portion 112 b. The third portion 116can comprise a structure that is located on a proximal facing edge ofthe end portion 114 b. In one embodiment, the third portion 116comprises a structure that extends between a generally proximal facingedge of a proximally located cell and a generally distal facing portionof a distal cell, where the proximal facing edge of the proximal cell islocated distal of the distal facing edge of the distal cell in adelivery state. Further, the edges of the first and second portions 112,114 can be smooth or rounded to further protect a patient's vasculature.

FIG. 10 is an enlarged plan view of another embodiment of a connector130. The connector 130 can be used to interconnect any desired portionof adjacent stent segments (having an open or closed cell structure,open serpentine pattern, or otherwise) and are, thus, not limited tointerconnecting bistable stent cells as illustrated in some of thefigures.

With reference to FIG. 10, the first and second portions 132, 134 of theconnector 130 can be configured to partially or fully surround aseverable or third portion 136 of the connector 130 such that, afterbecoming severed, the potentially rough or jagged edges of the severedthird portion 136 are shielded from the anatomy or adjacent portions ofthe stent. The third portion can be shielded by being partially or fullysurrounded in the axial, radial, and/or circumferential directions(similar to connector 18 described above), thereby reducing the level ofexposure of the severed connector 130. This configuration can prevent orreduce direct contact from the severed third portion 136 with otherportions of the stent or adjacent body tissue. Additionally, thethickness of the third portion 136 can be reduced in a radial directionto prevent or reduce direct contact from the severed third portion 136with other portions of the stent or adjacent body tissue.

As illustrated, the first and second portions 132, 134 can haveatraumatic, curved portions adjacent to the end portions 132 b, 134 b tofurther protect a patient's vasculature or other tissue and tosubstantially surround the third portion 136. The edges of the first andsecond portions 132, 134 can be smooth or rounded to further protect apatient's vasculature or other tissue. Further, the end surfaces 132 c,134 c of the first and second portions 132, 134 can be oriented in acircumferential direction (the circumferential direction being indicatedby arrow A1 in FIG. 10). The third portion 136 can be oriented in adirection that is normal to the end surfaces 132 c, 134 c of the firstand second portions 132, 134. In one embodiment, the third portion 136extends generally parallel to a longitudinal axis of a stent of which aportion is shown in FIG. 10. In this configuration, the smallestcross-sectional area of the third portion 136 is defined by a plane thatis normal to the longitudinal axis of the stent.

FIG. 11 is an enlarged plan view of another embodiment of a connector150. The connector 150 is similar to those hereinbefore described, e.g.,FIG. 10, except as described differently below and can be used in a widevariety of applications as discussed above.

As illustrated, first and second portions 152, 154 can have atraumatic,curved portions adjacent to the end portions 152 b, 154 b to furtherprotect a patient's vasculature or other tissue and to substantiallysurround a severable or third portion 156. The end surfaces 152 c, 154 cof the first and second portions 152, 154 can be oriented in an angulardirection defined by angle X relative to the circumferential directionof the stent (the circumferential direction being indicated by arrow A2in FIG. 11). The third portion 156 can be oriented in a direction thatis normal to the end surfaces 152 c, 154 c of the first and secondportions 152, 154.

In some embodiments, the angle X can be approximately 25 degrees.However, in some embodiments, the angle X can be from approximately 10degrees or less to approximately 45 degrees or more, or fromapproximately 20 degrees to approximately 35 degrees, or to or from anyvalues within these ranges.

FIG. 12 is an enlarged plan view of another embodiment of a connector160. FIGS. 13-17 are enlarged plan views of other embodiments ofconnectors. In some embodiments, the connectors shown in FIGS. 13-17 canhave any of the same features of the embodiment of the connector shownin FIG. 12, except as described below.

The connector 160 can be used to interconnect any desired portion ofadjacent stent segments or stent cells (not illustrated). In someembodiments, the embodiment of the connector 160 illustrated in FIG. 12can be configured to sever or break when a predetermined load, level offatigue, or displacement is experienced by the connector 160, while alsobeing configured to shield adjacent body tissue, stent material, orother adjacent objects from contact with the severed portion of theconnector 160 after the connector 160 has severed.

With reference to FIG. 12, the first and second portions 162, 164 of theconnector 160 can be configured to partially or fully surround aseverable or third portion 166 of the connector 160. In thisconfiguration, after becoming severed, the edges of the severed thirdportion 166 can be partially or fully surrounded by the first and/orsecond portions 162, 164, thereby reducing the level of exposure of thesevered third portion 166. For example, in some variations, the thirdportion 166 can be shielded in any one or more of the axial, radial, andcircumferential directions by the first and second portions 162, 164 ofthe connector 160. This configuration can prevent or reduce directcontact from the severed third portion 166 with other portions of thestent or adjacent body tissue. Additionally, the thickness of the thirdportion 166 can be reduced in a radial direction to further shield apatient's vasculature or other tissue from the potentially rough orjagged edges of the severed third portion 166.

As illustrated, the first and second portions 162, 164 can each havelooped or curved end portions 162 b, 164 b to substantially surround thethird portion 166. The curved end portions 162 b, 164 b advantageouslycan be oriented such that they are disposed between the ruptured ends ofthe connector 160 and other portions of the stent or adjacent bodytissue to prevent or reduce direct contact from the ruptured ends withother portions of the stent or adjacent body tissue after the thirdportion 166 has been severed. This arrangement can limit interactionsbetween a severed portion of the connector 160 and stent cells or otherstructures providing scaffolding of the vessel. Further, the edges ofthe first and second portions 162, 164 can be smooth or rounded toprovide greater protection to a patient's vasculature or other tissue.

Additionally, with reference to FIG. 12, the third portion 166 can haveone or more openings 168 (one being illustrated) formed through theconnector 160. In some embodiments, the opening 168 can be oriented in aradial direction relative to the stent. Alternatively, the opening 168can be oriented in a circumferential or a longitudinal directionrelative to the stent. The opening 168 can be sized and configured toreduce the cross-sectional area of the third portion 166, so that thethird portion 166 is designed to break or sever under a predeterminedlevel of cyclic fatigue, a predetermined load, or a predetermineddisplacement.

In some embodiments, as in the illustrated embodiment, the opening 168can be located in the approximate widthwise center of the third portion166 of the connector 160. In other embodiments, the opening 168 can beoff-center, or positioned adjacent to one of the side surfaces of thethird portion 166 so as to be open on one side, similar to the opening178 of the connector 170 illustrated in FIG. 13.

In some embodiments, as in the illustrated embodiment, the opening 168can have a generally circular shape, as illustrated in FIG. 12. In otherembodiments, the opening can have a generally square shape, asillustrated in FIG. 13, or any other generally rectangular, ovular,triangular, slit-like, or other suitable shape. In some embodiments, theconnector can have more than one opening formed therein, such as withthe embodiment of the connector 190 illustrated in FIG. 15. Withreference to FIG. 15, two generally triangular openings 198 can beformed in the connector 190, each being adjacent to the opposing sidesurfaces of the third portion 196 of the connector 190.

FIGS. 13-15 also illustrate that in some embodiments, a portion of aconnector can be configured with a reduction in cross-sectional area,such as by providing a recess in the connector to reduce the width at alocation between the ends of the connector. In these embodiments, thereduction in width can be due to an incursion from a side of theconnector portion toward a middle portion of the connector. In contrast,in the embodiment of FIGS. 12 and 17 (discussed below), a through-holecan be provided in a mid-portion of a length of the connector to reducethe amount of material in cross-section at a specific location along thelength of the connector. In some embodiments, rather than a through-holeor incursion creating a recess, the material can be thinned to reducethe cross-sectional area of the material, thus providing a pre-selectedfacture zone in the connector.

FIG. 14 is an enlarged plan view of another embodiment of a connector180. As illustrated, the connector 180 can have generally curved firstand second portions 182, 184, and a generally square or rectangularopening 188 formed in a third portion 186 of the connector 180. Thecurvature of the first and second end portions 182 b, 184 b can be moregradual than in the embodiment of the connector 170 illustrated in FIG.13 so that the third portion 186 maintains a more circumferentialorientation than the third portion 176.

In some embodiments, the curvature of the end portions of the first andsecond segments of the connector can be more pronounced or spiral-likeor otherwise provide multiple areas of overlap in a longitudinal orother direction of the stent. For example, with reference to FIG. 16, insome embodiments, the end portion 204 b of the second portion 204 of theconnector can form a nearly complete, but open, loop or spiral. As withother embodiments, a third portion 206 of the connector can bepositioned adjacent to the ends of the first and second portions 202,204 of the connector 206. The third portion 206 can have a reducedcross-section as compared to the first and second portions 202, 204, orcan have a similarly sized cross-section as compared to the first andsecond portions 202, 204.

In some embodiments, as illustrated in FIG. 17, the third portion 216 ofthe connector 210 can have an opening 218 therein, the opening beingapproximately centered with respect to an enlarged portion 219 of thethird portion 206 of the connector 210. In some embodiments, as in theillustrated embodiment, the enlarged portion 219 of the connector 210can be approximately triangular shaped, and the opening 218 can beapproximately circular shaped. Also, the embodiment of FIG. 17 providesan arrangement in which the opening 218 (which can be a thinning of theconnector rather than a complete through-hole) has a width that is equalor substantially equal to the width of adjacent portions of theconnector. The enlarged portion 219 is provided to temporarily bridgefrom a distal connector portion to a proximal connector portion. Forexample, in some embodiments discussed herein the connector comprises afirst portion, a second portion, and third portion disposed between thefirst and second portions. The first and second portions need not beclearly structurally separate or separable stent portions, but rathercan be a length of the connector extending from adjacent to a point ofconnection with cells on either side of the connector. For example, thefirst portion can be coupled at one end with a distal stent cell andextend a length generally proximally therefrom and the second portioncan be coupled at one end with a proximal stent cell and extend a lengthgenerally distally therefrom. In the embodiment of FIG. 17, the enlargedportion 219 can bridge between the first and second portions of theconnector. The enlarged portion 219 also can border the opening 218.

FIG. 18 is an enlarged plan view of another embodiment of a connector230, wherein the severable portion 236 of the connector 230 is directlysupported by the adjacent stent cells 14. The connector 230 can be usedto interconnect any desired portion of adjacent stent segments (havingan open or closed cell structure, open serpentine pattern, or otherwise)and is, thus, not limited to interconnecting the type of stent cellsillustrated in FIG. 18.

With reference to FIG. 18, the stent cells 14 can be configured topartially or fully surround a severable portion 236 of the connector 230such that, after becoming severed, the potentially rough or jagged edgesof the severed severable portion 236 are shielded from the anatomy oradjacent portions of the stent. The third portion can be shielded bybeing partially or fully surrounded in the axial, radial, and/orcircumferential directions, thereby reducing the level of exposure ofthe severed portion 230. For example, as illustrated, the end portions14 a of each of the stent cells 14 can be curved and otherwiseconfigured to partially surround the severable portion 236 of theconnector 230. This configuration can prevent or reduce direct contactfrom the severed third portion 236 with other portions of the stent oradjacent body tissue. Additionally, the thickness of the severableportion 236 can be reduced in a radial direction to further shield apatient's vasculature or other tissue from the potentially rough orjagged edges of the severed severable portion 236.

FIG. 19A is an enlarged view of another embodiment of a connector 250that can be used with any of the stents disclosed herein, showing theconnector 250 in a first or extended position. For example, withoutlimitation, the connector 250 can be used in place of some or all of theconnectors 18 for the stent 10 described above. Any of the stentsdisclosed or incorporated by reference herein can comprise any number,combination, or configuration of the connector embodiments disclosedherein. Further, the connector 250 or any other connector disclosedherein can be used to interconnect any desired portion of adjacent stentsegments (having an open or closed cell structure, open serpentinepattern, or otherwise) and are, thus, not limited to interconnectingbistable stent cells as illustrated in some of the figures.

With reference to FIG. 19A, the connector 250 can be used tointerconnect a first stent cell 14 a with a second stent cell 14 b. Theconnector 250, or any connector disclosed herein, can be positioned atany desired location on the stent segment. As illustrated in FIG. 19A,the connector 250 is positioned approximately at the apex of each of thestent cells 14 a, 14 b. The connector 250, or any other connectorsdisclosed herein, can be positioned off-center from the apex of thecells or bends in the case of serpentine or open cell designs, closer tothe thicker strut of the stent cells, off-center from the apex of thestent cells or bends in the case of serpentine or open cell designs, orotherwise. Further, the stent cells 14 a, 14 b can be arranged in anydesired orientation, including the arrangement shown in FIG. 19A inwhich the stent cells 14 a, 14 b are arranged in opposite orientations.In one embodiment, the cells are asymmetrical about a longitudinal axisand adjacent cells along the length of the stent are oriented 180degrees from each other about the longitudinal axis. For example, in oneembodiment, the cells each comprise a circumferentially wider strut anda circumferentially narrower strut and adjacent cells are oriented suchthat the circumferentially wider struts are on opposite sides of thelongitudinal axis. In FIG. 19A, the strut 14 a is circumferentiallywider than the strut 14 b and the struts 14 a, 14 b are located onopposite sides of a longitudinal axis extending generally long thelength of the connector 250.

The connector 250 can have a first portion 252 and a second portion 254slidably engaged with the first portion 252. As illustrated, the firstportion 252 can define a longitudinal opening 258 having a first endportion 258 a and a second end portion 258 b. The longitudinal opening258 can be configured to slidably receive at least a portion of thesecond portion 254 so as to compensate for any foreshortening orlengthening, or axial compressive or tensile forces exerted on the stent250. The second portion 254 can have a tab 262 positioned at a distalportion of the second portion 254. The tab 262 can have a size largerthan the width of the longitudinal opening 258, or otherwise beconfigured to prevent the second portion 254 from becoming disengagedfrom the first portion 252. The tab 262 can face either radially outward(e.g., on the outside surface of the stent, as illustrated) or radialinward (e.g., on the inside surface of the stent), or otherwise beconfigured so that interference with a cover or body tissue (such as thevessel wall) is minimized.

FIG. 19B is an enlarged view of the embodiment of the connector shown inFIG. 19A, showing the stent portion to which the connector is coupled ina second or contracted position. As illustrated in FIG. 19B, the stentcells 14 a, 14 b have moved more closely together, which can compensatefor compressive forces from bending, or from foreshortening of thevessel in which the stent is deployed or otherwise. The connector 250also can move from the second position of FIG. 19B to the first positionof FIG. 19A to compensate for foreshortening of the cells 14 a, 14 b andthus minimize foreshortening of the stent in some embodiments. The firstand second portions 252, 254 can define any desired size orconfiguration, so as to accommodate a wide range of desired translationdistances.

In some embodiments, the first portion 252 can be defined by a generallytubular shape having a longitudinal opening therein configured toslidably receive the second portion 254. Either or both of the first andsecond portions 252, 254 can comprise detents, protrusions, channels, orother features configured to limit the range of translation of thesecond portion 254 relative to the first portion 252, or otherwise beconfigured such that the second portion 254 is at least inhibited frombecoming disengaged from the first portion 252 of the connector 250.

FIG. 20A is an enlarged view of another embodiment of a connector 280that can be used with any of the stents disclosed herein, showing theconnector 280 in a first or extended position. For example, withoutlimitation, the connector 280 can be used in place of some or all of theconnectors 28 for the stent 10 described above. Any of the stentsdisclosed or incorporated by reference herein can comprise any number,combination, or configuration of the connector embodiments disclosedherein. Further, connector 280 or any other connector disclosed hereincan be used to interconnect any desired portion of adjacent stentsegments (having an open or closed cell structure, open serpentinepattern, or otherwise) and are, thus, not limited to interconnectingbistable stent cells as illustrated in some of the figures.

With reference to FIG. 20A, the connector 280 can be used tointerconnect a first stent cell 14 a with a second stent cell 14 b. Theconnector 280, or any connector disclosed herein, can be positioned atany desired location on the stent segment. As illustrated in FIG. 20A,the connector 280 is positioned approximately at the apex of each of thestent cells 14 a, 14 b. The connector 280, or any other connectorsdisclosed herein, can be positioned off-center from the apex of thecells or bends in the case of serpentine or open cell designs, closer tothe thicker strut of the stent cells, off-center from the apex of thestent cells or bends in the case of serpentine or open cell designs, orotherwise. Further, the stent cells 14 a, 14 b can be arranged in anydesired orientation, including the arrangement shown in FIG. 20A inwhich the stent cells 14 a, 14 b are arranged in opposite orientations.

The connector 280 can have a first portion 282 and a second portion 284slideably engaged with the first portion 282. As illustrated, the firstportion 282 can define an opening 288 at a distal or second end 282 b ofthe first portion 282. In some embodiments, the second end portion 282 bof the first portion 282 can be configured to project radially inwardlysuch that the opening 288 is oriented in an axial direction so that thesecond portion 284 can project through the opening in an axialdirection.

The opening 288 can be configured to slidably receive at least a portionof the second portion 284 so as to compensate for foreshortening orlengthening, or axial compressive or tensile forces exerted on the stent280. The second portion 284 can have a tab 292 positioned at a distalportion of the second portion 284. The tab 292 can have a size largerthan a width or other dimension of the opening 288, or otherwise beconfigured to prevent the second portion 284 from becoming disengagedfrom the first portion 282. In this configuration, the second portion284 of the connector 280 can be permitted to slide on the radiallyinward side of the first portion 282 of the connector, so thatinterference with a graft cover or body tissue (such as the vessel wall)is minimized.

FIG. 20B is an enlarged view of the embodiment of the connector shown inFIG. 20A, showing the connector in a second or contracted position. Asillustrated in FIG. 20B, the stent cells 14 a, 14 b have moved moreclosely together, to compensate for stent axial foreshortening,compressive forces from bending, or otherwise. The first and secondportions 282, 284 can define any desired size or configuration, so as toaccommodate a wide range of desired translation distances.

FIGS. 21 and 22 are perspective views of an embodiment of a helicallyarranged stent 350 having one or more severable connectors 358, showingthe stent 350 in a compressed state and an expanded state, respectively.The stent 350 can have any of the same features, configurations, orother details as any of the stent embodiments disclosed in U.S. patentapplication Ser. No. 11/391,940, filed on Mar. 29, 2006 (entitled“FRACTURE-RESISTANT HELICAL STENT INCORPORATING BISTABLE CELLS ANDMETHODS OF USE”), which patent application is hereby incorporated byreference as if fully set forth herein. Spiral or helical stents canhave a tendency to unravel or stretch or compress in an uncontrolledfashion when deployed. In some embodiments, it may be preferred to havea more axially rigid structure for deployment to maintain goodscaffolding and coverage, and to avoid such uncontrolled deploymentproblems.

Accordingly, the connectors 358 can be arranged in an axial directionbetween adjacent or closely positioned cells. The embodiments of theaxial connectors disclosed herein can be configured to interconnectbistable or non-bistable cells of axially adjacent segments, or tointerconnect bistable or non-bistable cells of adjacent helicallyarranged stents, or otherwise.

Additionally, the connectors 358 can be formed from the same material asthe stent cells or any other suitable material, or can be partially orcompletely formed from a biodegradable or bioabsorbable material asdescribed above. In some embodiments, the connectors 358 can bepositioned at any desired helical position, or can be linearly arrangedalong one or more sides of the stent 350. In this configuration, theconnectors 358 can sever when predetermined or threshold compressive,tensile, shear, or torsional forces are imparted on the stent or theconnectors.

FIG. 23 shows a plan view of an embodiment of a stent 400 having aplurality of stent segments 12 comprising a plurality of stent cells 14.In some embodiments, the stent cells 14 of each segment 12 can beinterconnected in a circumferential direction. In use, the stent 400 candefine a generally straight or curved cylindrical or tubular shape. Thestent 400 can comprise bistable cells, multistable cells, deformableunit cells, open cells, self-expandable cells, balloon or othermechanically expandable cells, any other cells currently known or laterdeveloped, or any combination of the foregoing. Further, in someembodiments, the stent segments 12 can have an open stent pattern(serpentine or otherwise) comprising a series of concave and convexbends, or any other suitable structure. In this preferred embodiment,the design eliminates tissue prolapse between rings. The materialconnecting the rings keeps them oriented such that the apex of each cellalternates with the other. Thus when the 2 rings move or merge togetherduring foreshortening the apices move into the recess between individualcells. This allows some circumferential coverage in the elongated andforeshortened state as shown in 24A.

In some embodiments, one or more adjacent stent segments 12 can beinterconnected by one or more wire connectors 402 that can be configuredto pass through one or more of the stent cells 14 (as illustrated) or,for open stent patterns (not illustrated), through one or more of theconcave or convex bends. The wire connectors 402 can comprise a suitablesuture material (biodegradable or otherwise), a metal alloy such asstainless steel or Nitinol, or any other similar or suitable material.In some embodiments, the wire connectors 402 can improve the scaffoldingprovided to the vessel wall by the stent 400, and can also help maintainthe appropriate alignment and spacing of the stent segments 12 duringballoon expansion.

The wire connectors 402 can be configured to permit a predeterminedamount of relative axial, circumferential, or radial displacementbetween adjacent stent segments 12 to accommodate axial foreshorteningor stretching, bending, or other loads or stresses. Some embodiments ofthe stent cells 14 of one segment 12 can be interdigitated relative tothe stent cells 14 of an adjacent segment 12 (as illustrated in FIG.23A) to increase scaffolding and also accommodate a greater magnitude ofaxial movement of one stent segment 12 relative to an adjacent stentsegment 12.

Additionally, as mentioned, the wire connectors 402 can be formed from abioabsorbable or biodegradable material that is configured to degrade orbe bioabsorbed by the body after a predetermined period of time. In thisconfiguration, the connector can be weakened so as to be more easilyseverable after a predetermined period of time, or can be completelybioabsorbed so as to remove the connection between adjacent stentsegments after a predetermined period of time. Further (notillustrated), in some embodiments, one or more of the adjacent stentsegments 12 of the stent 400 can be interconnected by one or moreseverable connectors of any of the types disclosed herein, incombination with or alternatively to having a wire connector 402interconnect one or more adjacent stent cells 14 or stent segments 12.

FIGS. 24-25 are plan views of a portion of additional embodiments of astent having a connector between at least two portions of a stent cell14 or stent segment 12. In particular, FIGS. 24-26 illustrate differentways in which the wire connector 402 can be joined to or engaged withthe stent cells 14 or open cell segments.

In some embodiments, the wire connectors 402 can form a double loop 404around one or more struts of a stent cell 14 (as illustrated in FIG.24A) or bends of an open stent structure (not illustrated). In someembodiments, depending on the material comprising the wire connector402, the double loop 404 can permit some slippage or axial movement ofthe wire connector 402 relative to the stent cell 14.

In some embodiments, the wire connectors 402 can form a lock knot 408around one or more struts of a stent cell 14 (as illustrated in FIG.24B) or bends of an open stent structure (not illustrated). In someembodiments, depending on the material comprising the wire connector402, the lock knot 408 can substantially inhibit or prevent slippage oraxial movement of the wire connector 402 relative to the stent cell 14.In some embodiments, any combination of double loops 404 or lock knots408 can be used to interconnect one or more adjacent stent cells 14 orstent segments 12. The connector 402 preferably prevents out-of-phasecell ring rotation during deployment. One goal here is to facilitateorientation of the rings after deployment and provide some scaffoldingfor tissue prolapse.

Alternatively, in some embodiments, one or more of the stent cells 14(as illustrated in FIG. 25) or bends of an open stent pattern (notillustrated) can support substantially or completely closed loops oreyelets 412 having an opening 414 therein configured to receive a wireconnector therethrough. The wire connector 402 can form double loops,lock knots, or other suitable connections with the loops 412.

FIG. 26 is a plan view of a portion of another embodiment of a stent 450having a connector 452 between at least two adjacent stent segments 12of a stent. The connector 452 can have a generally helical shape,comprising one or more loops. In some embodiments, the connector 452 canhave two or more loops.

Additionally, in some embodiments, as in the illustrated embodiment, theconnector 452 can have endpoints 454 that are circumferentially offsetfrom one another so as to not be aligned longitudinally. In particular,the connector 452 can have a first endpoint 454 a that is attached tostent cell 14 a, and a second endpoint 454 b that is attached to stentcell 14 b. The endpoints 454 can be circumferentially offset by one ormore cells 14. In some embodiments, as in the illustrated embodiment,the endpoints 454 a, 454 b can be circumferentially offset by two ormore cells 14. In other embodiments (not illustrated), the endpoints 454can be approximately longitudinally aligned when the stent 400 is in acollapsed state, an expanded state, or otherwise.

In some embodiments, a diameter of the connector 452 (as represented byD1 in FIG. 26) in the expanded state of the stent 450, can beapproximately the same as, or slightly larger than, the relaxed insidediameter of the target vessel or passageway to provide additionalscaffolding to the vessel. In some embodiments, the diameter D1 of theconnector 452 in the expanded state of the stent 450 can beapproximately as large as the size of three expanded cells 14.

Some embodiments of the stents disclosed herein can be configured suchthat no longitudinal connectors are positioned between two or more ofthe adjacent stent segments in a stent. In some embodiments, the entirestent be configured such that no stent segments are interconnected withconnectors. Further, any of the stents or stent segments disclosedherein can be covered with a graft material, such as without limitationePTFE. In some embodiments, portions of the stents or stent segments canbe sutured to the graft material.

Further, in some embodiments, stent segments 12 (whether or not axialconnectors are positioned between adjacent stent segments) can bedeployed in a patient's vasculature or passageway such that a gap orspace between adjacent stent segments (represented by d2 in FIG. 35) isapproximately 15% of the axial length of one or more of the stentsegments 12 (represented by d1 in FIG. 35), when the vessel orpassageway is in a relaxed state. In some embodiments, stent segments 12(whether or not axial connectors are positioned between adjacent stentsegments) can be deployed in a patient's vasculature or passageway suchthat a gap or space between adjacent stent segments is fromapproximately 5% to approximately 50% of the axial length of one or moreof the stent segments 12, or from approximately 15% to approximately 35%of the axial length of one or more of the stent segments 12, when theblood vessel or passageway is in a relaxed state.

Additionally, some stent embodiments disclosed herein can have spaces orgaps between some of the adjacent stent segments, and connectors orsutures between other adjacent stent segments of the same stent. Withreference to FIG. 35A, stent 500 is configured to have one or moreconnectors 16 between adjacent stent segments (or rings) 12 a, 12 b,between adjacent stent segments (or rings) 12 c, 12 d, and betweenadjacent stent segments (or rings) 12 e, 12 f. In some embodiments,severable connectors can be used in place of the connectors 16 shown inFIG. 35A. Further, the stent 500 can be configured such that there is agap or space 502 between adjacent stent segments (or rings) 12 b, 12 cand between adjacent stent segments (or rings) 12 d, 12 e. Havingconnectors between pairs of adjacent stent segments 12 can increase thestability of the each of the interconnected stent segments of the pairby inhibiting each of the stent segments 12 of the pair from rolling,flipping, or otherwise rotating out of its proper orientation relativeto the vessel lumen. Therefore, the connectors between each pair ofstent segments 12 can be used to bias each ring of the pair to maintainan open orifice or passageway through the vessel. In some embodiments,all or any number of adjacent stent segments can have a gap or spacetherebetween.

FIGS. 27-37 set forth additional details regarding some embodiments ofthe stents and connectors disclosed herein.

Although the inventions have been disclosed in the context of a certainpreferred embodiments and examples, it will be understood by thoseskilled in the art that the present inventions extend beyond thespecifically disclosed embodiments to other alternative embodimentsand/or uses of the inventions and obvious modifications and equivalentsthereof. In addition, while a number of variations of the inventionshave been shown and described in detail, other modifications, which arewithin the scope of the inventions, will be readily apparent to those ofskill in the art based upon this disclosure. It can be also contemplatedthat various combinations or subcombinations of the specific featuresand aspects of the embodiments may be made and still fall within thescope of the inventions. For example, in some embodiments, the features,configurations, or other details disclosed or incorporated by referenceherein with respect to some of the connector or stent embodiments arecombinable with other features, configurations, or details disclosedherein with respect to other connector or stent embodiments to form newembodiments not explicitly disclosed herein. All of such embodimentshaving combinations of features and configurations are contemplated asbeing part of this disclosure. Additionally, unless otherwise stated, nofeatures or details of any of the stent or connector embodimentsdisclosed herein are meant to be required or essential to any of theembodiments disclosed herein, unless explicitly described herein asbeing required or essential.

Additionally, the connector embodiments disclosed herein can be used tointerconnect any suitable stent structures, and can be configured toattach to or be supported by any suitable portion of the stent segments,stent cells, or other stent structures. For example, some embodiments ofthe connectors can be configured to be connectable to the apex of astent cell, a portion of the stent cell adjacent to the apex, to thestruts of the stent cells, or otherwise. Breakable inter-connectconfigurations can be on or off apex, valley to valley, valley to apexin various open and closed cell designs.

Accordingly, it should be understood that various features and aspectsof the disclosed embodiments can be combined with or substituted for oneanother in order to form varying modes of the disclosed inventions.Thus, it can be intended that the scope of the present inventions hereindisclosed should not be limited by the particular disclosed embodimentsdescribed above.

What is claimed is:
 1. An expandable medical device for treating anendolumenal passageway, comprising: a first circumferential supportstructure having one or more closed cells; a second circumferentialsupport structure having one or more closed cells, the secondcircumferential support structure being proximal of the firstcircumferential support structure; and an interconnect having a proximalend passing through one or more closed cells of the secondcircumferential support structure, a distal end passing through one ormore closed cells of the first circumferential support structure, and anelongate portion extending between the proximal and distal ends, theinterconnect having a first state providing a continuous materialbetween the proximal and distal ends of the interconnect therebyengaging the first and second circumferential support structures, theinterconnect having a second state in which a gap is provided therealongthereby disengaging the first and second circumferential supportstructures; wherein the interconnect enters the second state when theexpandable device experiences a predetermined axial force orforeshortening.
 2. The expandable device of claim 1, wherein theinterconnect comprises a wire connector.
 3. The expandable device ofclaim 2, wherein the wire connector comprises a thread structure that iscollapsible in compression to facilitate foreshortening of theexpandable device.
 4. The expandable device of claim 2, wherein the wireconnector comprises a material that biodegrades when in contact withhuman blood.
 5. The expandable device of claim 2, wherein the wireconnector comprises a helical strand having at least one turn disposedbetween the first and second circumferential support structures.
 6. Theexpandable device of claim 2, wherein the wire connector is a metalalloy.
 7. The expandable device of claim 1, wherein the interconnect ismade of the same material as the first and second circumferentialsupport structures.
 8. The expandable device of claim 1, wherein thefirst and second circumferential support structures comprise closedcells extending entirely around a central axis of the expandable device.9. The expandable device of claim 1, wherein the one or more closedcells of the first circumferential support structure or the secondcircumferential support structure are chosen from bistable cells,multistable cells, deformable unit cells, self-expandable cells, balloonexpandable cells, and mechanically expandable cells.
 10. The expandabledevice of claim 1, wherein the interconnect keeps the first and secondcircumferential support structures oriented so that an apex of each cellalternates with an apex of another cell.
 11. The expandable device ofclaim 1, wherein the interconnect comprises a metal alloy.
 12. Anexpandable medical device for treating an endolumenal passageway that issubject to axial foreshortening, comprising: a first circumferentialsupport structure; a second circumferential support structure, thesecond circumferential support structure being proximal of the firstcircumferential support structure; and a moveable interconnect having afirst portion connected to the first circumferential support structureand a second portion connected to the second circumferential supportstructure, the first and second portions of the moveable interconnectconfigured to be slidably coupled to one another, wherein the firstportion includes a continuous piece of material that defines alongitudinal opening within the continuous piece of material and havinga first end portion and a second end portion, wherein the second portionof the moveable interconnect comprises a tab positioned at a distalportion of the second portion, wherein the first portion is defined by atubular shape having the longitudinal opening.
 13. The expandable deviceof claim 12, wherein the tab has a size larger than a width of thelongitudinal opening.
 14. The expandable device of claim 12, wherein thetab can face radially outward or radially inward.
 15. The expandabledevice of claim 12, wherein at least one of the first portion and thesecond portion comprises detents or channels that limit the range oftranslation of the second portion relative to the first portion.
 16. Theexpandable device of claim 12, wherein the interconnect is positioned atan apex of a cell.
 17. The expandable device of claim 12, wherein theinterconnect is positioned off-center from an apex of a cell of thefirst circumferential support structure or the second circumferentialsupport structure.